Peripheral parenteral nutrition in surgery – a systematic review and meta-analysis

Khan, Ayman; Laing, Erin; Beaumont, Anna; Wong, Jean; Warrier, Satish; Heriot, Alexander G.

doi:10.1016/j.clnesp.2023.02.004

Cited by 5 publications

(2 citation statements)

References 40 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Peripheral access should be favored over central access to reduce the risk of infection and thrombosis. Some strategies to reduce the risk associated with peripheral access in surgical patients, such as cyclical infusion through the 18 G cannula or using silicone or polyurethane cannulas in addition to anti-phlebitis solutions, have been recently proposed and may also be applicable to SCI patients [ 77 ]. When positioning vascular access, limb mobilization should be allowed.…”

Section: Resultsmentioning

confidence: 99%

What We Do and What We Should Do Against Malnutrition in Spinal Cord Injury: A Position Paper From Italian Spinal Cord Injury Network Rehabilitation Centers

Areni,

Capeci,

Cassinis

et al. 2024

J Clin Med Res

View full text Add to dashboard Cite

Spinal cord injury (SCI) is a traumatic event that significantly impacts body composition and alters energy and nutritional needs. This places patients with SCI at a high risk of malnutrition, which can hinder optimal functional recovery, prolong hospital stays, increase hospital admissions, and contribute to the development of obesity and cardiovascular and metabolic ailments in chronic patients. Consequently, there is an urgent need for clear guidance to support clinicians in managing the nutritional needs of patients with SCI at different stages of the disease, including the acute (0 - 4 months after injury), post-acute (4 - 26 months after injury), and post-discharge phases. This study utilized a cross-sectional survey to assess the strategies employed in seven spinal units across Italy to address the nutritional needs of patients with SCI during the acute, post-acute, and post-discharge phases of the condition. Eight clinicians (five physiatrists, two internists, and one urologist) and one nurse participated in the survey. Following the survey completion, the participants were invited to partake in a round table session to delve deeper into the questionnaire results to gather their opinions and gain insights into clinical practices related to the various challenges surrounding the management of malnutrition in patients with SCI. We here review the available evidence on the energy needs and nutritional requirements of patients with SCI, highlighting the clinical aspects that deserve more attention throughout the distinct phases of the disease. We additionally provide an overview of the scenario regarding the management of malnutrition in patients with SCI across various spinal units in Italy. Through this comprehensive analysis, we aimed to enhance understanding and provide valuable insights for clinicians working with patients with SCI, equipping them with the knowledge and confidence to provide nutritional support to patients with SCI efficiently. By addressing the challenges of defining nutritional needs and presenting a practical guide, we aspire to contribute to the overall management and care of individuals with SCI and the prevention of malnutrition and its associated complications, thereby improving patient outcomes.

show abstract

Section: Resultsmentioning

confidence: 99%

What We Do and What We Should Do Against Malnutrition in Spinal Cord Injury: A Position Paper From Italian Spinal Cord Injury Network Rehabilitation Centers

Areni,

Capeci,

Cassinis

et al. 2024

J Clin Med Res

View full text Add to dashboard Cite

show abstract

“…PICC can be used for administering intravenous medications with high osmolarity or vesicant infusions. However, PICC may not accurately transmit the central pressure ( 9 ). Midline catheters (MC) are often characterized by their shorter length compared with PICC, as well as their peripheral placement resulting in the tip not being positioned centrally ( 10 ).…”

Section: Introductionmentioning

confidence: 99%

Peripheral vascular access as exclusive access mode in pediatric intensive care unit

Armstrong,

Gangu,

West

et al. 2023

Front. Pediatr.

View full text Add to dashboard Cite

IntroductionThe type of vascular access (central or peripheral) in pediatric critical care depends on several factors, including the duration of treatment, the properties of the medication (osmolarity or vesicant), and the need for central pressure monitoring. The utilization of peripheral intravascular catheters (PIVCs) has shown a notable increase in the number of patients being treated. Extended dwell or midline catheters are another peripheral access option in addition to PIVCs. However, there are currently no established guidelines on their placement.ObjectivesThe aim of this study is to estimate the duration of dwell time for PIVCs, analyze the specific parameters affecting it, and develop recommendations for switching to extended dwell and midline catheter placement as an alternative to peripheral access.MethodsThe study enrolled patients aged 0–18 years admitted to the pediatric intensive care unit (PICU) for over 24 h and managed with peripheral access only over 2 years (2019–2021).Measurements and main resultsA total of 484 patients met the specified criteria. Patients who had peripheral access exhibited a lower PRISM score and a shorter length of stay in the PICU, with mean values of 18 (SD: 8.5) and 9.5 (SD: 6.4) days, respectively, compared with patients who had central access with mean values of 8.9 (SD: 5.9) and 5.7 (SD: 3.6) days, respectively. The PIVC dwell time was found to be 50.1 h (SD: 65.3) and required an average of 1.6 insertion attempts. Patients with three or more insertions exhibited an increased odds ratio of 5.2 (95% CI: 3.1–8.5) for receiving an extended dwell or midline insertion. Increased dwell time was associated with female gender, 59.5 h (P < 0.001), first attempt insertion, 53.5 h (P < 0.001), use of 24 Ga bore, 56.3 h (P = 0.04), left-sided insertions, 54.9 (P = 0.07), less agitation, 54.8 h (P = 0.02), and less edema, 61.6 (P < 0.001). Decreased dwell time was associated with the use of vancomycin infusion at 24.2 h (P < 0.001) and blood transfusions at 29.3 h (P < 0.001).ConclusionsExtended catheters last longer than PIVCs in PICU patients. Extended catheter placement requires consideration of the length of treatment, as well as the overall body edema, the level of the patient's restlessness, and the need for vancomycin infusion or blood transfusions, as these factors reduce PIVC dwell time and expose the patients to painful insertions. For such cases, an extended dwell catheter may be a better option, even if the projected treatment time is less than 6 days.

show abstract

Peripheral parenteral nutrition: A retrospective observational study to evaluate utility and complications

Bidgood,

Huang,

Murphy

et al. 2024

Nut in Clin Prac

View full text Add to dashboard Cite

BackgroundPeripheral parenteral nutrition (PPN) provides an alternative nutrition support strategy to centrally administered PN for specific patients requiring short‐term PN. Previous studies have demonstrated limited use of PPN and variable complication rates. This study aimed to evaluate PPN complications and usage at this center.MethodsThis was a single‐center retrospective observational study of all adult patients who received at least 1 day of PPN from June 2018 to December 2023. Demographic and clinical data were collected, including complications, indications for PN and reason for PPN, duration of therapy, reason for cessation of PPN, nutrition status, energy and protein provision, and central line insertion rates.Results381 patients were included, the median age was 62 (interquartile range = 28–74) years, and 235 were men (61.7%). The most common indication for PN was ileus (n = 153, 40%) followed by gastrointestinal obstruction (n = 93, 24%). The median time receiving PPN was 3 (2–4) days. Patients received a median of 65% (55%–75%) of energy and 58% (50%–69%) of protein requirements with PPN. Malnutrition was diagnosed in 47.5% (n = 181) of this cohort. Total complication rates were 8.7% (n = 33), with cannula infiltration being the most common complication (6.6%, n = 25). 213 (56%) patients proceeded to central line insertion.ConclusionPPN proved to be a safe and effective therapy for short‐term PN when managed by a nutrition support team. PPN has the potential to attenuate short‐term nutrition deficits and prevent central venous access device insertion in selected patients, making it a valuable nutrition support therapy.

show abstract

Peripheral parenteral nutrition in surgery – a systematic review and meta-analysis

Cited by 5 publications

References 40 publications

What We Do and What We Should Do Against Malnutrition in Spinal Cord Injury: A Position Paper From Italian Spinal Cord Injury Network Rehabilitation Centers

What We Do and What We Should Do Against Malnutrition in Spinal Cord Injury: A Position Paper From Italian Spinal Cord Injury Network Rehabilitation Centers

Peripheral vascular access as exclusive access mode in pediatric intensive care unit

Peripheral parenteral nutrition: A retrospective observational study to evaluate utility and complications

Contact Info

Product

Resources

About